It's Plantar Fasciitis!

You get out of bed one morning and your foot hits the ground. "OUCH!" What's causing this pain? You walk around getting ready for work and the pain seems to be disappearing. "Phew", you have to go for your 10 miler after work. The next day the same thing happens. Eventually, you feel the pain every time you stand. AND even when you are running! Finally, after a week you decided to do a Google search - plantar faciitis.
You roll, you ice, you wear a sock thing at night, but nothing changes.

What is plantar fasciitis?

Plantar Fascitis is the inflammation of the fascia (connective tissue) on the bottom of your foot. It spans from the heel to the toes. At the beginning stages,  the tissue gets stretched with weight bearing however over time, with each step the tissue gets more inflamed.

What are the risk factors plantar fasciitis?

A systematic review of journal articles on plantar fasciitis was performed in 2008 and revised in 2014. The big risk factors for getting plantar fasciitis are being a runner, a person who stands for work and limited ankle dorsiflexion. We all all know you're not going to stop running or working, so let's focus on what we can change.

Limited ankle dorsiflexion
This means the ankle joint has a limited mobility to flex the foot towards the body. Ankle dorsiflexion is required to have proper mechanics while running. When ankle dorsiflexion is limited, the sequence of movement of the foot is changed, putting more stress onto the plantar fascia.
Tightness of the calf muscles ( gastrocnemius and soleus) can also contribute to limited dorsiflexion. Connective tissue from the calf spans down into the heel and blends into the plantar fascia. Limited mobility of the calf muscles can contribute to increase stress of the plantar fascia.

Treatment

Ball Roll on Calf 

Most people with plantar fasciitis know to roll the bottom of their foot on a tennis ball or golf ball. However, there is a myofascial pain referral zone at the base of the calf where the muscle becomes tendon. This zone is slightly to the outside of the center of the muscle tendon junction. In a long sit position, use a roller or a lacrosse ball to roll out the area for 2-5 minutes depending on tolerance.

'X' marks the spot

Ankle Mobilization

Lace Lock method

When you can't have a therapist to follow you around, you have to improvise. Using a running shoe is the perfect substitute to assist in self mobilizations. Tie shoes using the lace lock method. Thread the lace on the same side through the last hole. Pull the opposite lace through the hoop. Tie the shoes really tight across the front of the ankle. In standing, put one foot in front and rock forward allowing the knee to bend to mobilize the ankle. Angle the knee to go over the pinky toe. Then angle the one to go over the big toe.
5 times each direction
*** Only tie the shoes laces very tight when mobilizing!!

Calf Stretch with Tri- Plane Tweak

This is a tri-planar tweak on the standard calf stretch. Stand with one foot forward and use knee to drive the motion forward. Then twist left and right. Lastly sway your hips side to side.
Perform 10-15 repetitions

Out of the box

In normal mechanics, the hip and thoracic spine absorbs lateral and rotation motion respectively as the arms swing back and forth. However, if those regions are stiff, the motion is transferred to the ankle. The ankle is forced into an over supinated position. In the supinated position the foot is unable to absorb shock putting more stress on the plantar fascia. Improving mobility in the hips and thoracic spine will take the stress off the plantar fascia.
Please refer to earlier post on stretching the hip and thoracic spine.

http://3drunner.blogspot.com/2015/03/spine-stiffness.html
http://3drunner.blogspot.com/2014/06/ankle-sprain-how-thoracic-spine-and-hip.html

By addressing limitations locally in the ankle and globally at the hip and thoracic spine, you achieve a more comprehensive treatment plan.

Compression Band for Plantar Fasciitis, Ankle Sprains and Knee Pain

At the request from multiple people, this post is focused on how to use a compression band (voodoo band) for the lower extremity. The feedback I receive after being wrapped is the treatment area feels lighter, more mobile and less achy. This is does not fix an injury but a way to manage your symptoms.

On the left is a home-made compression band from a bike tube.
On the right, is the compression band aka. voodoo band

How the compression band works

The band works by providing a compression onto the connective tissue. Imagine our connective tissue as a kitchen sponge. When it is being used, the sponge soaks up dirt and grime. When the sponge is compressed the dirty fluid is squeezed out and upon release fresh water is absorbed. By pushing stagnant fluid out and allowing fresh fluid to enter, our soft tissue is lubricated and mobility is restored! Drink Water!

How to use the compression band

Stretch the band about 50-75% and cover half of the prior band. I recommend performing stepping motions in all 3 planes of motion to maximally compress the different aspects of the connective tissue. The band stays on for no more then 2 minutes maximum!


DO NOT use the band if you have peripheral vascular disease, peripheral neuropathy or being treated for cancer. Take the compression band off if the tissue becomes gray, have numbness and tingling or have sudden claustrophobia

The band can be purchased online or you can cut a bike tube in half and split down the middle for a flat band. Note: A bike tube is much shorter then the 7-foot band and you'll smell like rubber.

I will demonstrate on to use the band for the lower extremity - foot, ankle and knee. 
The band can help reduce symptoms associated with plantar fascia, ankle sprains, Achilles tendonitis and general knee pain. 

Plantar Fasciitis 

Start the wrap at the base of your toes and wrap around the foot and onto the ankle. Tuck the end in. You can perform toe curls and extensions, ankle pumps and ankle circles. For the best effect perform a lunge matrix. 

Ankle Sprains and Pain

For ankle sprains, start the band the base of the ankle. Always start the band distal to the ankle to push the swelling into the leg to be absorbed. You want to cover the skin as much as you can so the swelling doesn't get pushed into the uncompressed area. Covering the entire surface around the ankle can be tricky. I recommend completely covering the heel with one circle and angling the ankle down.

This method can also be used for Achilles tendonitis.

Knee pain 

Start the band below the kneecap. You should have enough the cover the entire knee. Tuck the end of the band under the. You can bend and straighten your knee at different angles or contract your quadriceps muscles. My recommendation...  a lunge matrix!

The band can also be used around your muscles such as quadriceps and calf. 

Please see your MD if your pain is a chronic or serious injury.

Those who have use this please comment and give your feedback!

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